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Can ultrasound diagnose scaphoid fractures?

Report by: Jonathan Baldry, ST5 emergency medicine

Search checked by: Jim Crawfurd, Consultant emergency medicine

Institution: James Paget NHS Trust, Great Yarmouth, UK

Clinical scenario

A 24-year-old man presents following a fall on an outstretched hand. He has clinical signs of a scaphoid fracture but his initial x-rays are normal. You wonder if ultrasound could be used to identify an occult scaphoid fracture.

Three-part question

In an (adult presenting after wrist trauma with clinical signs of a scaphoid fracture but normal x-rays), can (ultrasound imaging) detect the presence of an (occult scaphoid fracture)?

Search strategy

Medline, CINAHL, and Embase databases using Ovid interface in June 2010.

Mesh terms (scaphoid bone) and (ultrasonography).

Keyword search: (scaphoid bone OR Carpal bones OR Fractures OR wrist injuries OR un-united) AND (Ultrasonography OR Ultrasonics OR Interventional Ultrasonography OR Ultrasound OR Sonography OR High-intensity Focused OR High-intensity focussed).

Outcome

Twenty-one relevant articles were …

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